Identify and discuss with EMR vendors to distinguish appropriate relevant companies that can meet organization needs. Hospital IT representative to review requested EMR product information.
Individual Project Plan
As a culminating project, this assignment has two parts: an executive summary and a project plan created in either Microsoft Project or Apple Merlin. Those experiencing problems with Project software may complete this portion of the assignment in Excel. Use prior course information and data gathered for your CLC Business Plan to complete this assignment.
Write an executive summary of your CLC Business Plan. You will also submit the project in either Microsoft Project or Apple Merlin (or Excel as a substitute). The purpose is to make sure YOU understand the project and what will be required in your Capstone.
Guidelines: Write a project plan in Microsoft Project or Apple Merlin. Excel may be substituted as needed.
1. Examine your CLC Business Plan: Extract the distinct activities needed to start up the business: (a) Identify tasks needed to complete the project. (b) Develop a completion schedule. (c) Assign resources to project tasks.
2. Be creative. For example: If your plan calls for three nurses, you will need to plan for hiring, and training. Create arbitrary timelines for each activity. They could be very general (2 weeks to hire, 2 weeks to train) or they could dive much deeper (1 week to write hiring ad, 1 week to place ad, 2 weeks to accept applications, 1 week to review, 3 weeks for interviews, 1 week for offer-letters, 2 weeks to establish in HR system, etc.). Do this for each section of the CLC Business Plan.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Here is my business plan
1. Description of Product or service:
Product
Electronic Medical Record (EMR) is a popular technology that facilitates systematic collection and storage of individual or population health records. EMR also enhances faster sharing of information among healthcare professionals. The technology also includes critical patient data such as billing information, patient age and sex, vital signs, laboratory test results, medical history, and immunization status. The technology has so far proved reliable in increasing hospitals effectiveness and efficiency. Therefore, the adoption of EMR in the hospital will be useful in reducing the possibility of data replication. The technology will also support quick sharing of information among all stakeholders (Ribeiro?Neto, Laender, & De Lima, 2001).
Mission
The inclusion of EMR aims at advancing the quality of service delivery and the hospital competition advantages. The technology will equally be essential in minimising unnecessary wastage of time in retrieving patients’ information. Additionally, EMR will facilitate effective sharing of information among primary care physicians in all hospital clinics. The hospital also aims at increasing the quality of services offered in the hospital (Poissant & Kawasumi, 2005).
2. Business and industry profile:
Hospital profile
Sacred Heart HC System is one of the most successful healthcare facilities in the region. The hospital has the capacity of 200 beds. In addition, the hospital has 30 prominent primary care physicians. The hospital also has four clinics situated in various parts of the region. Furthermore, the hospital has one hospital-based clinic that offers both the outpatient and in-patient services. However, in order to advance its competition advantages and advance the quality of service delivery, the hospital is planning to adopt Electronic Medical Records. The electronic medical records will be essential in facilitating faster recovery of patients’ medical history and other reliable health information
Action plan
The identification of the necessary resources will be the initial step towards implementing the EMR project in the hospital. The EMR implementation resources will include financial resources, human resources, and time. Secondly, the hospital will select a reliable vendor for the EMR software. The selection of reliable software will be useful in ensuring that the technology attains its intended objective. The staffing of the plan will equally be vital in facilitating the success of the hospital EMR project. The staffing of the project will involve the selection of the most essential skills, training of staffs, and ensuring effective teamwork among all involved actors. The hospital will also identify the most appealing location for the EMR equipment. The identification of the location for the project will entail creating space for locating the necessary equipment and setting working station for employees.
Training of staffs on the benefits of the technology in their operations will also be another critical step towards facilitating the success of the project. Staffs will also get the necessary training on how to integrate the project in their operations. Physicians will also get training on the most reliable mean of using the technology to advance their service delivery. In addition, project implementers will ensure that the EMR adequately integrate current electronic data resources. In order to attain in objectives, EMR project needs to connect with other sources of data such as quality software, dictation, laboratory, imagining, and billing. The project manager should also consider other social and economic factors such as language of potential customers, customers’ literacy, and culture. In addition, project implementers have the mandate of ensuring that the project in implemented within a set timeline (Kmetik, Bossley, & Bufalino, 2005)
So far, the hospital is among the most successful business in the region. The hospital has managed to recruit and maintain successful and promising healthcare practitioners. In addition, the business has been registering high profit in the last three years. Furthermore, the hospital has included modern technology in their operations with limited restrictions. However, due to the lack of modern technology such as EMR, the hospital has been losing some of its clients to new market entrants. The hospital efficiency has also been deteriorating due to lack of the necessary technology. As a result, the business intends to spend some of its resources in installing EMR in its operations. EMR will be essential in ensuring quality and fast service delivery. The adoption of EMR technology will also help the hospital use the opportunity presented by modern technology in advancing its profitability and effectiveness. The inclusion of EMR will equally be reliable in advancing the hospital competition advantages. The available empirical evidence further reveals that that EMR will largely minimise the operation and management cost in the hospital (Wang, Middleton, Prosser &Bates, 2013).
3. Marketing Components
Primary care in Essex region is provided mainly through doctors’ offices, small to medium sized clinics and five other region’s hospitals. Vendor XXX EMR is built around its advocacy and support for small practices as well as for the hospitals with a provision delivery of coordinated care through advanced technology. Company has taken a proactive approach to retains customers and build relationships which is vital in a competitive service industry.
Marketing goals and objectives:
The goal of the marketing strategy is to place Vendor XXX EMR as the primary resource for electronic medical records products, implementation and support source for all the primary practices in Essex region. The following objectives will assist in achieving the above goals:
1. Generating wide community awareness of the Vendor XXX EMR products and service portfolio.
2. Establishing a name brand awareness that is unique with the service and support provided for the EMR activities.
3. Web strategy approach to maximize the promotions to generate more than 50% of EMR product inquiries through the Vendor XXX EMR website.
Target market:
Vendor XXX EMR provides software & services for mid-size and large medical groups, hospitals and other integrated health care facilities. The system required by each practice differs based on their unique needs to meet the specialized knowledge. The services mainly provided by the above facilities are mainly family practices, OBGYN, paediatrics or internal medicine and general surgeries. The practices have majority of Medicare /Medicaid patients. As the demand for nationwide EHR adoption increases the Vendor XXX EMR company also matures and the product line expands to include the following customers:
• Small to medium sized practices
• Clinics – community health centres, community health centres, small hospitals, hospital outpatient clinics.
• Long term care organizations- nursing homes
• Correctional health facilities
• State agencies
• Hospitals – larger than 300 bed capacity facilities
Customers have been classified into levels based on Vendor XXX EMR expects to have products and services designed for them. Level 1 customer will benefit from the initial product line and will be suitable for Vendor XXX EMR in the first year of operations. The product line will expand to meet the products designed for level 2 in late 4Q10.
The following Customer Demographic Profile table lists Vendor XXX EMR customer types, the targeted levels and basic characteristics of each customer type.
CUSTOMER TYPE TARGET LEVEL DEMOGRAPHIC INFORMATION
Doctor’s offices
Primary and specialty areas Level 1 Pilot: Practices that meet pilot criteria like EMR adoption readiness by fall 2014
Clinics and ambulatory clinics Level 1 Clinics that meets readiness criteria
Small hospitals Level 1 Hospitals with less than 250 beds and are located in Essex region.
Hospital outpatient clinics Level 1 Primary health clinics which provide care through residency training programs and meet readiness criteria.
Behavioral health facilities Level 2 Behavioral health care providers looking for EMR adoption
Long term care facilities Level 2 Facilities provides skilled nursing long term care and assisted living
Correctional facilities Level 3 Facilities provide care for incarcerated inmates in state and county facilities.
Practices require trustworthy resources to assist in the selection, implementation, and management of EMR. Providers are recognizing EHR adoption may not be a choice for much longer, federal incentives are designed for encouraging adoption and non-adopters will face penalties. To receive the stimulus fund it is significant to meet the ARRA criteria by practices. Vendor XXX EMR can address these issues to all potential customers by ensuring a quality product and through their support services function. The initial product offering will be towards meeting the needs of level 1 customer, product development for the other levels are in the Vendor XXX EMR product development plan which can be speeded up from the increased demand from customers.
Competitive advantages:
Vendor XXX EMR will have EHR products enhanced by personal service and support. By providing ongoing support from initial implementation onwards will enhance the providers to achieve maximum value and meaningful use. Vendor XXX EMR will offer services and expertise at an affordable rate, with tools and training for staff on how to use their EMR and achieve EMR optimization. Vendor XXX EMR has multiple competitive advantages.
• Vendor XXX EMR can assist you with criteria in each stage of meaningful use as they are developed and formulated and can help to maximize the long-term advantageous effects of stimulus initiatives.
• Clinicians and community health care leaders can attest to Vendor XXX EMR’s products and rigorous selection process because of the direct participation in the selection of initial EMR service.
• Vendor XXX EMR is the only Essex regional based collaborative in EMR implementation.
• Discounts on other products and services are an important factor compared to other resources.
• Vendor XXX EMR is composed to assist the providers interested in ARRA incentives but lack knowledge regarding product and level of effort required to initiate the process.
• Adaptable and accelerated with innovative approaches.
Market Research and analysis:
Electronic medical records have been available since the late eighties, latest technology advancement and innovations in health care industry along with federal laws by U.S Governments ( 2009 HITECH/ARRA legislation) has made entry of EHR systems within reach of small practices also. This made the EHR industries rapid growth to a multi-billion dollar business sector. There are hundreds of EHR companies most of them are small privately held technology companies, which is a concern for small practices due to lack of resources to fully evaluate products or companies. EHR market requires a resource that can simplify the options and decision- making process. According to The New England Journal of Medicine (2013), “As of May 2012, a total of 62,226 eligible professionals had attested to meaningful use under the Medicare program. This represents 12.2% of the estimated 509,328 eligible physicians in the United States, including 9.8% of specialists and 17.8% of primary care providers (PCPs).” During the last quarter of 2013, a survey was conducted among local health care providers and 60 % of respondents have an EMR and the rest expressed interest to access features of Vendor XXX EMR. The adoption rate by physicians and hospitals are showing an upward trend, the recent study by the National Ambulatory Medical Care Survey (NAMCS) “during 2007–2012, use of any type of EHR system and adoption of a basic system both increased in all categories of physician specialty and practice size, however only two-fifths of physicians had adopted basic system by 2012, and less than one-quarter had adopted a fully functional system”. This research is important for the Vendor XXX EMR since the products will be implemented in phases with an option for providers to start with a basic model and build towards a fully functional system.
Significance of Vendor XXX EMR:
Specialty resources are available from Vendor XXX EMR for issues such as limited staff with EMR knowledge, lack of skills & resources to select and implement appropriate EHR or simple lack of understanding of health information technology principals. Vendor XXX EMR will provide basic education regarding information technology principles for the EHR novice and also to advanced EHR user. Website will provide information and resources regarding HIT and EHR which will create an understanding regarding the Vendor XXX EMR offers and services. Success of Vendor XXX EMR is based on the one –on-one customer support and personal guidance through the implementation cycle which assist the practices to achieve EHR optimization. This enables the practices to receive the Federal ARRA incentives.
Advertising and promotional plans:
Vendor XXX EMR will be promoted as provider advocate for EMR, an incredible source of general information and a trust worthy company for purchase of EMR for clinics and hospitals. Pricing is fixed for up to six years. Providers, professional organizations, state agencies, stake holders, service partners, universities and consumer groups are vital to the success. Outreach efforts done through ongoing communications and involvement. The advertising message – Vendor XXX EMR is for customer satisfaction and the providers know they can rely confidently on the quality services.
On line marketing strategies is available through the main site Vendor XXX EMR.org
Updated contents will include:
• Organization, purpose, mission, products and services
• EMR and service packages
• Resources to provide education on EMR and related links for providers and patients.
• Training sessions
• Current marketing materials related to EHR
• User group hub
• Interactive tools and services and demonstrations
The combined use of marketing strategies and promotional efforts of Vendor XXX EMR will guide the target markets to first understand the value of an EMR which is essential prior to the purchase of EHR.
4. Financial information
Sacred Heart HC System selected VENDOR XXX electronic medical record system to replace our present system to go beyond typical clinical data collection in our hospital and clinics for a broader assessment of patient care and the community at large. Achieved advantages to Sacred Heart will be enhanced revenue management, reduced costs, improved diagnostics and outcomes, improved care coordination, medical practice efficiencies, reduced hospital readmission, and improved provider performance.
After due diligence VENDOR XXX will achieve Sacred Heart key goals and specific needs for both hospital and clinic operations. Start-up pricing for customized reports, exchange (HIE) connection to additional providers, laboratory interface, phased payments over 3 years for software, hardware, maintenance, and future upgrades have been established. Implementation support, training, server options, integration with Sacred Heart existing systems, and ongoing connectivity needs have been ascertained. The following EMR pricing table demonstrates breakdown of VENDOR XXX pricing:
EMR Pricing Breakdown
License Fee 7,500
Portal Provider Monthly fee annualized 7,500
Portal Activation Fee 10,150
Provider Implementation 2,100
Provider Training 17,000
Lab Interface Fee 11,400
Lab Implementation 2,500
Lab Interface Training 8,500
HIE Connection Fee 12,500
HIE Connection Implementation 5,750
Other Interface Fees Integration old system 1,600
Patient Education Monthly Free
e-Prescribing Monthly Fee- Free
Maintenance Monthly Fee-annualized 15,000
Total Hardware/software Development 70,000
Total Implementation Fees All Components 103,483
Total Training Fees – All Components 17,000
Total System Cost 190,483
In overall cost to Sacred Heart, VENDOR XXX component consideration was given to:
• Hardware: Scanners, printers, tablets/laptops, desktop computers, and data base servers.
• Ongoing Network Fees and Maintenance: Clinical data analysis, IT operations staff, telecom fees, education, and software licensing agreements.
• Training: Provider training, nurses, office staff, new workflows.
• Implementation Assistance: Installation, workflow redesign, consultant support, electrician, IT contracting.
• EMR Software: Interface modules, upgrades, lab interface, EHR applications.
An EMR budget was established listing initial investment, benefits to operations, associated costs, net benefits with a calculated Net Present Value (NPV) of $10, 209, internal rate of return of 17.4%, and payback period in years of 2.25.
Initial Investment in EMR Year 1 Year 2 Year 3
Hardware $25,000
Software $35,000
Development $10,000
Total Initial Investments $70,000
Benefits from EMR to Operations
Helps prevent hospital readmissions $50,000 $50,000 $50,000
Improved provider performance $12,000 $12,000 $12,000
Medical practice efficiencies and cost savings $25,000 $25,000 $25,000
Improved care coordination $10,000 $10,000 $10,000
Reduced customer service costs $ 7,500 $ 7,500 $ 7,500
Improved diagnostics and outcomes $15,000 $15,000 $15,000
Costs (excluding initial Capital Investments)
Monthly subscription cost annualized $ 7,500 $ 7,500 $ 7,500
Maintenance $15,000 $15,000 $15,000
Project management, customer service $35,000 $35,000 $35,000
Online advertising, registration $10,000 $10,000 $10,000
Depreciation $23,333 $23,333 $23,333
Hosting, domain name registration $ 150 $ 150 $ 150
General and administrative $10,000 $10,000 $10,000
Training expense – hospital & clinics $17,000 0 0
License fee $ 2,500 $ 2,500 $ 2,500
Total costs $120,483 $103,483 $103,483
Net Benefits (Costs) ($983) $ 16,017 $ 16,017
Tax (88) $ 1,442 $ 1,442
Value after tax (895) $ 14,575 $ 14,575
Depreciation added back $ 23,333 $ 23,333 $ 23,333
Cash flow ($70,000) $ 22,439 $ 37,909 $ 37,909
Cumulative cash flow ($70,000) ($47,562) ($9,653) $ 28,256
Evaluation Metrics
Net present value (NPV) $10,209
Internal rate of return 17.4%
Payback period in years 2.25
Sacred Heart Pro-forma Income Statement
Revenues 2014 2015 2016
Gross Revenues $5,000 $5,700 $7,200
Less contractual allowances 2,000 2,300 2,800
Net Revenues $3,000 $3,400 $4,400
Cost of Operations
Beginning Billings $3,500 $3,600 $4,200
Plus Non-medical Billings 1,200 1,650 1,850
Total Medical Billings $4,700 $5,250 $6,050
Less Discounts 3,600 4,200 4,350
Total Operating Income $1,100 $1,050 $1,700
Gross Profit (Loss) $1,900 $2,350 $2,700
OPERATING EXPENSES
Sacred Heart Hospital and Clinic Operations
Salaries and wages $350 $410 $460
Insurance 120 140 160
Refund adjustments 44 51 62
Depreciation 140 150 160
EMR System Expense 120 103 103
Total Medical Expense $774 $854 $945
General/Administrative
Salaries and wages $120 $140 $160
Employee benefits 40 50 55
Payroll taxes 20 30 32
Medical Supplies 60 60 70
Rent 80 80 90
Utilities 20 20 22
Depreciation & amortization 30 40 41
Office supplies 10 10 12
Laboratory 30 30 32
Telephone/Cable 10 11 12
Equipment maintenance & rental 50 55 56
Interest 12 12 14
Furniture & equipment 3 4 5
Total General/Administrative Expenses $485 $542 $601
Total Operating Expenses $1,259 $1,396 $1,546
Net Income Before Taxes $641 $954 $1,154
Taxes on income 220 320 325
Net Income $421 $634 $829
PROJECTED BALANCE SHEET
Sacred Heart HC System
Historical Projected
12/31/2013 12/31/2014
ASSETS
Current Assets
Cash in bank $ 550,000 $ 723,000
Accounts receivable 300,000 337,000
3rd Party Contractual Allowances 75,000 86,000
Prepaid expenses 17,000 27,000
Other current assets – –
Total Current Assets $ 942,000 $ 1,173,000
Fixed Assets
Machinery and equipment $ 600,000 $ 580,000
Furniture and fixtures 400,000 380,000
Capital acquired 120,000 125,000
Land and buildings 3,000,000 2,800,000
Other fixed assets 144,000 140,000
(LESS accumulated depreciation on all fixed assets) (275,000) (320,000)
Total Fixed Assets (net of depreciation) $ 3,989,000 $ 3,705,000
Other Assets
EMR System $ 190,483
Deposits 159,000 200,000
Leasehold improvements 175,000 165,000
Other 34,000 22,000
Total Other Assets $ 368,000 $ 507,000
TOTAL Assets $ 5,299,000 $ 5,385,000
LIABILITIES AND EQUITY
Current Liabilities
Accounts payable $ 400,000 $ 530,000
Interest payable 155,000 160,000
Taxes payable 85,000 103,000
Notes, short-term (due within 12 months) 175,000 140,000
Current part, long-term debt 2,000,000 1,684,000
Other current liabilities 388,000 275,000
Total Current Liabilities $ 3,203,000 $ 2,892,000
Long-Term Debt
Bank loans payable $ 950,000 $ 930,000
Fund Balances 390,000 775,000
Property – Parking 345,000 325,000
Other long-term debt 131,000 129,000
Total Long-Term Debt $ 1,816,000 $ 2,159,000
Total Liabilities $ 5,019,000 $ 5,051,000
Equity
Invested capital $ 200,000 $ 225,000
Retained earnings – beginning 35,000 54,000
Retained earnings – current 45,000 55,000
Total Equity $ 280,000 $ 334,000
Total Liabilities and Equity $ 5,299,000 $ 5,385,000
Purchase of VENDOR XXX EMR system has no negative effect on Sacred Heart operations as demonstrated by projected Balance Sheet and pro-forma Income Statement. There is retained positive cash flow throughout projected future operating years for this purchase which is financed through existing normalized operations. Break-even analysis projects a healthy operating profit even with added EMR expense through years 2014-2016.
Break-Even Analysis
Sacred Heart HC System 2014 2015 2016
Gross Profit $1,900,000 $2,350,000 $2,700,000
Less Variable Expenses
EMR System Materials $70,000 $0 $0
EMR Labor Training Expense $17,000 $0 $0
EMR Implementation Expense $103,483 $103,483 $103,483
Other $0 $0 $0
Contribution Margin 1,709,517 2,246,517 2,596,517
Contribution Margin Ratio 89.97% 95.60% 96.17%
Fixed Expenses
Salaries and wages $495,000 $550,000 $620,000
Employee benefits $40,000 $50,000 $75,000
Payroll taxes $20,000 $30,000 $32,000
Rent $80,000 $80,000 $80,000
Utilities $20,000 $20,000 $22,000
Repairs and maintenance $100,000 $146,000 $150,000
Insurance $45,000 $40,000 $42,000
Supplies $70,000 $75,000 $77,000
Telephone $10,000 $11,000 $12,000
Postage $4,000 $4,120 $4,244
Office supplies $10,000 $10,000 $12,000
Laboratory $30,000 $40,000 $44,000
Marketing/promotion $25,000 $30,000 $35,000
Professional fees $80,000 $90,000 $104,000
Training and development $1,000 $1,030 $1,061
Refund Adjustments $140,000 $125,000 $130,000
Depreciation $77,000 $80,000 $90,000
Interest Expense $12,000 $14,000 $16,000
Other $0 $0 $0
Total Fixed Expenses 1,259,000 1,396,150 1,546,305
Total Fixed Expenses Ratio 66.26% 59.41% 57.27%
Break-Even Sales 1,399,284 1,460,462 1,607,932
Break-Even % 73.65% 62.15% 59.55%
Operating Profit 450,517 850,367 1,050,213
5. Operational plan:
Our strategic operating plan for our new EMR system is monitored by our senior leadership to ensure the plan adheres to our time tables and assumptions. External conditions (economic, political, and legal) may affect the operating plan causing senior leadership to modify the plan due to unanticipated changes in order to retain synchronization. This operating plan for implementation of a new EMR system requires diversity of resources. Plan requires allocation of physical plant office space in hospital and our clinics, and considerable management time on department agendas. Our physician, IT, and administration leaders will make elections based upon priorities within our strategic initiatives and future operational needs.
1. Confer with EMR organizations regarding crucial requirements and available preferences and related pricing.
2. Practice physician’s consultation regarding specific essential requests.
3. Protocol delineated for decision making in selecting an EMR system and purveyor.
4. Formulate criteria and employ evaluation system options that are offered from EMR companies.
5. Request EMR proposals from suppliers
6. EMR Committee members discuss and analyze proposals (IT, Primary Care Physician (PCP), Administration, Medical Records, Director of Nursing [DON])
7. Choose EMR supplier and EMR system. Physician decision making involvement goal of 80 percent
8. Discuss and determine best option and negotiate with EMR supplier for purchase of EMR system and support services.
9. Finalize and sign for EMR system purchase contract with starting date in six months for implementation. EMR system cost not to exceed $200,000 dollars with service costs of $50,000 per month.
Time line
Week 1-3: Identify and discuss with EMR vendors to distinguish appropriate relevant companies that can meet organization needs. Hospital IT representative to review requested EMR product information.
Week 4-5: Confer with PCP to gain their input and needs analysis and discuss product capabilities. IT, admin, Physician leadership, to compile a list of preferred EMR system preferred capabilities. Perform a PCP survey of system preferences (IT, Admin, PCP lead). Conduct a second PCP meeting for discussion of EMR program capabilities and options (IT and all available PCP).
Week 6-7: Protocol for decision making determined based upon all gleaned information from wants and needs of organization, EMR vendor, and product capabilities and services. Prepare an outline of protocol for organization decision –making (Admin and IT). Dialog with PCP and Hospital leadership to reach determination. Complete the approved protocol for decision making (PCP leaders and Admin).
Week 8-9: Determine measures for EMR decision making utilizing information from PCP and EMR company vendor meetings (IT and Admin). Meeting with PCP leadership and administration leadership to discuss decision making criteria. Complete and gain approval on decision making procedure from Admin and PCP leadership.
Week 10-12: EMR proposals reviewed by EMR Committee (IT, Admin, PCP leadership, DON). EMR companies of interest invited for presentations (IT staff). Presentations scheduled for review by IT, PCP leaders, DON, and Admin with analysis by committee.
Week 13-15: Examination of all options with preparation of report on all evaluated EMR systems, companies, and associated services (IT and Admin) with intent to limit options to three EMR companies to evaluate.
Week 16: Final selection of EMR company and system and service plan. Meeting with PCP leadership, Administration, Director of Nursing, and IT for concluding EMR system search in agreement.
Week 17-18: Dialog initiated with selected EMR selected company VENDOR XXX with intent to close the transaction (Senior Administration, IT). Discussions completed, purchase agreements and service agreements completed (IT, senior leadership, legal counsel).
Contracts or leases:
Vendor XXX EMR staff will ensure EMR is implemented in timely manner and utilized to their fullest capacity. The major legal agreements include:
A major Contract- specifies the roles of the EMR vendor and organization and will include the terms and conditions of the partnership. All products, services, pricing etc. required to implement and maintain the EMR product offered are included. The contract term will be for five years.
A base Contract- agreement for the purchase of Vendor XXX EMR at a set price with each practice commit to vendor’s EMR service for a minimum of 24 months and with the choice to renew for up to 36 months at the same rate and terms. Additional services such as data conversion will be provided in discounted rates.
Staffing for design, implementation, training and future support:
EMR implementation is challenged mainly by human factors than the technological issues. The right leadership is critical component. The steering committee requires a lead member who has the authority to make final decisions; this can be a general practitioner for the ambulatory clinics and a C-level executive in a hospital. The rest of the interdisciplinary team consists of
• Project coordinator- Responsibilities are organization of team meetings, creation of ground rules, communication and documentation of team decisions, making sure of completion of task on-time, provision of resources for the team and in charge of maintaining the overall schedule.
• Information technology leader – This person will be in charge IT team for the deployment and operation of the software and hardware.
• Nurse Champion- a single super user or multiple super users based on the size and the type of the facility, who is well knowledgeable about the existing clinical work flows and to translate to electronic records.
• Physician Champion- single or multiple persons based on the need and function in an advisory role.
• Representatives from other services– members from other departments with EMR workflow implementation such as pharmacy, dietary, office front office administrator, billing etc.
“Training is a crucial part of successfully implementing an electronic health record (EHR) system. Although you may be tempted to skimp on it to save money, doing so could wind up costing your practice far more in the long run”(Peck, 2013, para. 1).The training involves 5 phases.
Phase 1 successful training program is based on assessment following factors.
• Clear vision for training the audience and their needs for easier adoption of EMR system effectively and fast.
• A clearly defined strategy (e.g., training schedules, training locations, staffing, applications).
• Any definite metrics for success. (e.g., meaningful use entry rates).
• Any comparison or assessment regarding organizations current training resources to the project goals.
• Documentation of available resources for the training program such as logistics, training class rooms, number of attendees etc.
Phase 2 – Based on the assessment phase planning and designing regarding course content for training, creation of schedules and training environment and preparation of training materials.
Phase 3- During this stage trainers and super users should get their credentials regarding EMR implementation in their specific areas of clinical work flow.
Phase 4- this is the most complex and expensive training phase due to the need of training the staff on courses based on their specific needs. Scheduling the staff for classes without compromising the clinical workflow can be challenging. Coordinating classes for physicians and the other health care disciplines adds additional complexities to this phase.
In addition to the class room training every workstation will have at least one practice computer with EHR set up of dummy patient to stimulate common scenarios along with web access of Vendor XXX EMR. Vendor XXX EMR will provide experienced trainers to guide and meet all required training requirements.
Service details:
Vendor XXX EMR will provide various services which are designed to amplify the EMR experiences. Pre-determined package services are provided for a set monthly fee with each Vendor XXX EMR subscription. One of the main features of Vendor XXX EMR is the built in features which assist the eligible hospitals and clinics to meet the clinical quality measures through achievement of stage 1 & stage 2 Meaningful use in order to receive the Medicare and Medicaid EHR incentive. “Clinical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals, and these measures use data associated with providers’ ability to deliver high-quality care or relate to long term goals for quality health care”(Clinical Quality…2014).
1. Information technology (IT) support –Vendor XXX EMR have technology experts who will guide the organizations to the appropriate technology and equipment to meet their service specific EMR selection.
2. Implementation assistance- Vendor XXX EMR will provide on-site implementation support throughout the implementation cycle. Coordinate or guide to resources available through professional organization.
3. User group and support group- User Group and support services will be organized and supported by the experts from the vendor XXX EMR to provide needed user feedback and methods to ensure that satisfactory end-user support mechanisms are available. This will include support groups, mentor programs, peer groups and forums to collect the feedback and back to the users.
4. Hardware, software and other support for discounted rate- Volume discounts are available for technology products which are required by the organizations to support the EMR system (scanners, computers, etc.).
5. Matching service for support services- Support services will be provided by a database of suppliers. According to the provider request company profiles and work evaluation results will be searched even when the product or service is not included in the purchased package. Different services are provided by these suppliers for e.g., data conversion and migration, documentation management, internet and network services, project management.
6. Monitoring of policy issues that affect EMR and related standards-Policy changes are communicated to providers, guidance on privacy and security issues.
7. Education- Learning tools are provide for the providers and the patients about EMR, Health Information Technology(HIT),Personal Health Information(PHI) and related issues to improve EHR awareness and to reduce the fear of sharing PHI which will increase the EHR adoption rate.
8. Billing and Financial services- pre-set financial arrangements with coordinated billing and payment services. Negotiated loan programs for EHR purchases for practices with a financial institution.
References
Clinical Quality Measures Basics. (2014)Retrieved from http://www.cms.gov/Regulations-and-
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